Evaluating the Effect of Translation on Spanish Speakers' Ratings of Medicare

This study examined the equivalence of the English and Spanish versions of the Medicare Consumer Assessment of HealthPlans Study (CAHPS) fee-for-service (FFS)survey among 2,996 Hispanic Medicare ben-eficiaries. Multigroup confirmatory factoranalyses indicated that with few exceptionsthe factor structures were very similar for theEnglish and Spanish surveys. However, itemresponse theory-based methods for investigat-ing differential item functioning (DIF)revealed that several items demonstratedthreshold-related DIF, suggesting thatrespondents in the two languages utilized theresponse options for the items differently.The results of this study suggest the need forfuture qualitative research to understandhow respondents comprehend the responseoptions in the two languages.